Laryngological manifestations of Sjögren’s syndrome

Kamiński, Bartłomiej

doi:10.5114/reum.2019.83237

Cited by 9 publications

(4 citation statements)

References 39 publications

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“…This reduction in saliva can lead to complications such as difficulty in swallowing (dysphagia), increased dental caries, and oral candidiasis. The decrease in saliva also affects taste and can cause a burning sensation in the mouth [8].…”

Section: Oral and Pharyngeal Manifestations: Xerostomia Dysphagia And...mentioning

confidence: 99%

ENT Manifestations of Sjögren’s Syndrome: A Comprehensive Narrative Review

Farrukh

2024

IJMBS

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Background: Sjögren's Syndrome (SjS) is a chronic autoimmune disorder predominantly affecting exocrine glands, leading to symptoms such as keratoconjunctivitis sicca and xerostomia. This review focuses on the ear, nose, and throat (ENT) manifestations of SjS, which significantly impact patient quality of life and pose diagnostic challenges. Aim: The review aims to consolidate current knowledge on the ENT manifestations of SjS, exploring pathophysiological underpinnings, clinical presentations, and treatment strategies, while addressing the diagnostic challenges associated with the disease. Review Summary: ENT manifestations in SjS include nasal dryness, recurrent sinusitis, otitis, and laryngeal dryness, which may precede other systemic manifestations, aiding in early diagnosis and management. This review highlights the importance of recognizing these symptoms for timely intervention, which can significantly improve disease prognosis. Future Implications: Understanding ENT manifestations can enhance multidisciplinary management approaches and foster development in diagnostic and therapeutic strategies, potentially improving patient outcomes and quality of life. Clinical Policy and Development: Enhanced awareness and training on the ENT aspects of SjS are recommended for healthcare professionals. Development of more sensitive diagnostic tools and personalized treatment plans could also address the variability in symptom presentation and response to treatment. Keywords: Sjögren's Syndrome, ENT Manifestations, Xerostomia, Keratoconjunctivitis Sicca, Multidisciplinary Management

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Section: Oral and Pharyngeal Manifestations: Xerostomia Dysphagia And...mentioning

confidence: 99%

ENT Manifestations of Sjögren’s Syndrome: A Comprehensive Narrative Review

Farrukh

2024

IJMBS

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“…Dryness of the mucosa of the upper respiratory tract is a predominant symptom and results in nasal, oropharynx, nasopharynx, laryngopharynx, vocal cord dryness, and dryness of the skin of the external auditory meatus. The main laryngological symptoms accompanying SS include the following: • Facial hypaesthesia and trigeminal nerve neuropathy, and multiple cranial neuropathy [30][31][32][33] Other possible laryngological manifestations of SS are early and progressive hearing loss and symptoms related to neuropathy of the eighth cranial nerve. Approximately, a quarter of patients suffer from high-frequency hearing loss of cochlear origin, as detected by impedance audiometry or auditory brainstem procedures.…”

Section: Laryngological and Otological Manifestations Of Ssmentioning

confidence: 99%

“…in peripheral neuropathy and ganglionopathy in trigeminal or ataxic neuropathies have been reported as the main pathogenic etiology. The rapid and almost complete recovery from nerve palsy after therapy with corticosteroids and azathioprine suggests that lymphocytic infiltrate, rather than a vasculitic process, was the cause of cranial neuropathy in SS [33][34][35][36][37][38][39][40].…”

Section: Laryngological and Otological Manifestations Of Ssmentioning

confidence: 99%

Laryngological and Dental Manifestations of Sjögren’s Syndrome

Kamiński¹,

Błochowiak²

2019

Chronic Autoimmune Epithelitis - Sjogren's Syndrome and Other Autoimmune Diseases of the Exocrine Glands

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Sjögren's syndrome (SS) affects numerous different areas, and many specialists may be involved in the diagnosis and treatment of SS. Otolaryngological and dental manifestations, neurological impairment, and hearing loss may be the initial symptoms of SS. This chapter describes the most common otolaryngological and oral manifestations of SS, its pathomechanism and possible etiology. Dryness accompanying SS is associated with many clinical implications. The rate of dry mouth in SS ranged from 41% at initial diagnosis to 84% 10 years after diagnosis. An unstimulated salivary flow rate of 0.1 ml/min in sialometry gives a score of 1 to the weighted sum of 5 items according to the current EULAR/ACR criteria. The presence of mononuclear cell aggregates around the ducts and acini of salivary glands results in functional and structural alterations at the level of these glands and impairs their secretory function. The most common oral signs and symptoms are dental caries, tooth decay, fungal infections, traumatic oral lesions, dysphagia, dysgeusia, and inflammation of the salivary glands. Saliva in SS is characterized by the increased concentration of lactoferrin, potassium and cystatin C and the decreased concentration of amylase, carbonic anhydrase, mucins, histatines, IgA, statherins, proline-rich proteins, and the loss of salivary buffer properties. The lack of these physiological defense mechanisms increases the risk of opportunistic infections, mainly fungal infections by Candida albicans. Candidiasis accompanies angular cheilitis, simple cheilitis, and exfoliative cheilitis. The salivary glands of SS patients are characterized by chronic inflammation with the presence of lymphocytic infiltrates located around the striated ducts. These periductal foci may lead to the development of organized ectopic lymphoid structures resembling secondary lymphoid organs with segregated T-and B-cell areas, and high endothelial venules. These structures become an active center of immune response. The presence of foci in labial salivary glands is a hallmark of SS, and their histopathologic analysis is an important item in the diagnosis and classification. A biopsy can be taken from either the labial or the parotid salivary gland, but currently according to the diagnostic criteria, only labial salivary gland biopsy (LSGB) is recommended to confirm the diagnosis of SS. The authors present their own experience and recommendations in taking labial salivary gland biopsy, the main surgical approaches, and the main limitations for this diagnostic method and describe the possibilities and principles of histopathological examination in SS. The authors present the main ultrasonic signs of SS major salivary glands and perspectives of the usage of salivary gland ultrasonic examination in the diagnosis and monitoring of SS. The presented chapter also includes the most common laryngological manifestations associated with SS: nose dryness, crusting, Chronic Autoimmune Epithelitis-Sjogren's Syndrome and Other Autoimmune Diseases... 2 or atrophy of th...

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“…Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease characterized by inflammation of the salivary and lacrimal glands, causing a reduction in exocrine secretion that ultimately leads to clinical presentation of sicca symptoms. 1 Aside from sicca syndrome, a typical symptom is chronic fatigue. The pSS is a heterogeneous disease that, in addition to dryness, presents with involvement of multiple organs and systems (extraglandular manifestations).…”

Section: Introductionmentioning

confidence: 99%

Differences in clinical phenotypes of primary Sjögren’s syndrome depending on early or late onset

Sebastian

Madej

Sebastian³

et al. 2021

Adv Clin Exp Med

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Background. Previous research suggests that systemic involvement in primary Sjögren's syndrome (pSS) is a marker of disease prognosis.Objectives. To evaluate pSS disease activity and the clinical phenotype of pSS patients depending on the age at diagnosis with long-term follow-up. Materials and methods.The study group consisted of patients diagnosed with pSS based on the 2016 pSS classification criteria.Results. The study group consisted of 46 patients with early-onset pSS (≤35 years of age) and 32 patients with late-onset pSS (≥65 years of age). The study group was identified from a total of 228 patients diagnosed with pSS. There were no differences regarding the frequency of eye and mouth dryness, focus score (FS) ≥1 or anti-SSA/SSB antibodies depending on age. Rheumatoid factor (RF) was more common among older patients (p > 0.05). In the overall assessment of disease activity using European League Against Rheumatism (EULAR) Sjögren Syndrome Disease Activity Index (ESSDAI), no differences related to age were observed on the first and last visit (after 36 months on average). Lymphadenopathy and changes in the hematology domain (p < 0.05) were more common in patients with the early-onset phenotype. Changes in the lungs and musculoskeletal system occurred regardless of age.Conclusions. Patients with early-onset pSS differ from those with late-onset pSS in terms of higher incidence of peripheral lymphadenopathy and cytopenia. The involvement of lung tissue and joints as well as dryness symptoms are common in pSS regardless of age. The RF plays a role in the pathomechanism of pSS development.

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Laryngological manifestations of Sjögren’s syndrome

Cited by 9 publications

References 39 publications

ENT Manifestations of Sjögren’s Syndrome: A Comprehensive Narrative Review

ENT Manifestations of Sjögren’s Syndrome: A Comprehensive Narrative Review

Laryngological and Dental Manifestations of Sjögren’s Syndrome

Differences in clinical phenotypes of primary Sjögren’s syndrome depending on early or late onset

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